Networks change. We verify your specific Florida Blue (Blue Cross Blue Shield of Florida) plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: Blue Cross Blue Shield of Florida, BCBS of Florida, BCBSFL, BlueOptions, BlueSelect, BlueCare HMO, myBlue, BlueChoice, Traditional Blue Select, BCBS HealthChoice. Offered in Florida.
Florida Blue is the largest health insurer in the state and the Blue Cross Blue Shield licensee for Florida. Its behavioral health benefits are administered by New Directions, now operating under the Lucet name, for many plan types, which means the network for psychiatry can differ slightly from the medical network. Most BlueOptions PPO plans cover psychiatry visits for a specialist copay or coinsurance, and BlueCare HMO plans cover them in network without a primary care referral for mental health. Telehealth psychiatry is covered at parity with office visits under Florida law and Florida Blue policy, and video visits are now a routine part of outpatient care for members.
Florida Blue's medical coverage guideline for transcranial magnetic stimulation covers TMS for major depressive disorder when you have had an inadequate response to at least two antidepressants from different classes, or intolerance, and have a documented symptom rating. Prior authorization is required, and the initial approval generally covers a standard course of around 36 sessions over six to nine weeks. Spravato is covered as a medical benefit with prior authorization and documentation of treatment-resistant depression, an oral antidepressant, and administration at a REMS-certified site. Members holding Blue Cross cards from other states are typically covered through the BlueCard program at our Florida and South Carolina offices.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Is Stedfast Psychiatry in network with Florida Blue?
Stedfast Psychiatry accepts most Florida Blue commercial plans, including BlueOptions and BlueCare products, at our Florida offices. Because Florida Blue uses a behavioral health administrator for some plans, we recommend calling the mental health number on the back of your card to confirm that your specific plan includes our providers before scheduling.
What will a visit cost with Florida Blue?
For most PPO plans, an outpatient psychiatry visit is a specialist copay, commonly $40 to $75, or coinsurance after the deductible on high-deductible and health savings account plans. HMO plans usually have a flat copay. Your summary of benefits lists the mental health outpatient cost share, and our staff can verify it before your visit.
Does Florida Blue cover telehealth with a psychiatrist?
Yes. Florida Blue covers video psychiatry visits at the same benefit level as in-person visits for members located in Florida at the time of the appointment. Telehealth is suitable for evaluations, medication management and follow-ups. Deep TMS and Spravato must be delivered in person at the offices that offer them.
Does Florida Blue pay for Deep TMS at Palm Beach Gardens?
Florida Blue covers TMS for major depressive disorder when its medical necessity criteria are met, which include documented failure of at least two antidepressants and a current severity score. Prior authorization is required. Our TMS coordinator assembles your medication history and submits the request, then schedules once approval arrives, usually within one to two weeks.
Does Florida Blue cover Spravato?
Florida Blue covers Spravato for treatment-resistant depression with prior authorization. You must be on an oral antidepressant and receive the spray at a certified clinic under observation. Both the drug and the monitoring visit are billed, so you may see two separate cost shares. We offer Spravato at Boynton Beach, Palm Beach Gardens and Royal Palm Beach.